Lifting Without Cutting #2: MyEllevate w/ Dr. Gregory Mueller

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Welcome to Park Avenue
Plastic Surgery Class,

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a podcast where we explore controversies
and breaking issues in plastic surgery.

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I'm your co-host, Doreen Wu,

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a clinical assistant at Bass
Plastic Surgery in New York City.

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I'm excited to be here with Dr. Lawrence
Bass, Park Avenue plastic surgeon,

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educator, and technology innovator.

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Today's episode is the
second in our series,

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"Lifting Without Cutting." This series
looks critically at all the non-surgical

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options to treat laxity
in the face and neck.

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Today we're going to discuss
MyEllevate. Dr. Bass,

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we've talked about neck lifting before
and energy-based treatments for skin

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lifting. What else is there?

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I feel like this is a key question for
everyone who is too young for a surgical

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neck lift,

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but they're seeing that
they need something to make
a real change in the neck

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area.

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I think you're absolutely right, Doreen.

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There's a huge cohort of people
who have done all the basic things,

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but they've aged enough that
they've lost their jawline.

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Their neck has a blunted look,

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but they're not ready for a surgical
neck lift. Fortunately, nowadays,

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there's another option called MyEllevate.

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There's a lot of detail to this story
about how and why it was developed

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and who is a good candidate
to help tell that story.

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I've invited the developer
of the procedure to join
us on this episode of the

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podcast.

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Dr. Gregory Mueller is a
plastic surgeon who trained at

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USC.

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He's board certified by the American
Board of Plastic Surgery and Practices in

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Beverly Hills,

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and he's the developer of this
ICLED technology that is the

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underpinning of the MyEllevate procedure.

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He's also innovated in
other areas in including the

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oVio360, which is an imaging system.

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And I love technology and I
love new things in plastic

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surgery.

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It's one of the exciting things about
plastic surgery that we get so many new

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options.

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So I'm very excited to have Dr. Mueller
join us and share his experience with

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MyEllevate.

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Well, thank you so much for having
me on the podcast today. And wow,

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what a journey it has been.

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This is something that has
been sort of my project,

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I would guess I would call
it my professional endeavor
since I first kind of

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thought about it up here in
2005 to where it is today.

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Welcome, and thank you for joining us
today. I'm excited to hear the story.

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So can you tell our listeners
how the development started?

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What problem were you trying to solve?

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Yeah, so I trained at University of
Southern California and finished there in

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1998 and went out into practice
and here in Beverly Hills and

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love doing facelifts and neck lifts
and opening the neck and so on.

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But what I recognized early on in my
practice was that a lot of people would

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come through the door and they were too
young to have a big facelift or neck

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lift procedure, or they were simply
just afraid of something so invasive.

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So I just thought there's got to be a way
to sew the neck muscles without really

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opening the whole front of the neck.
And that's where my search began.

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And I think it was my
experience of training in
general surgery where I saw the

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value of laparoscopic or
endoscopic techniques,

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and that's where the search began.

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I thought there's got to be a way
to see underneath the skin to sew.

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And one day I was using my
laparoscope, my endoscope,

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I had done an endoscopic brow lift and
Dr. Bass, you know how we use those.

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And I thought,

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I'm going to just look underneath the
neck skin and see maybe that I could do a

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endoscopic neck lift.

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And what I realized was the skin doesn't
really lift up and you don't have an

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optical cavity like you do when
you're doing an endoscopic brow lift.

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But I saw all the retaining ligaments
and I was looking at the skin and I saw

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the light come through the
skin and I thought, wow,

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if I had a needle that was illuminated,

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I can see where that needle was traveling.
And that's where it sort of started.

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That's great. And I've often said
on the podcast we're surgeons,

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we like doing big operations, but
patients don't like having big operations.

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And so if there's a way to avoid
that, it's always preferable.

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And I think the other thing it really
points up is that a lot of what's

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important about contouring
the face and neck is

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about the deeper tissues and not the skin.

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Everyone thinks about taking
out skin, taking out skin,

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and that's part of it to be sure,
particularly at the extreme of age.

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But structuring the deeper tissues is

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really essential.

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So to try to make it clearer
what the procedure accomplishes,

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maybe you could walk our listeners
through the steps of the procedure.

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Sure, sure. So in simple terms,

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what it works like is it works as if you
were taking your fingers and literally

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just kind of pushing up right underneath
your ear lobes to lift everything up.

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And we all know how that looks in the
mirror. We like the way that looks.

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And so what we're doing basically is
injecting numbing fluid under the skin,

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which separates and lifts the skin
up from the underlying muscle.

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So it creates a little
passage that you can use.

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And between the skin and the muscle are
all these attachments called ligaments,

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and we literally use the lighted
needle and thread to pass through that

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space.

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The surgeon watches the
skin on the outside and they
see the light come through

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the skin, and we start in the center.

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We go up one side right around the
jaw line behind the ear circle around,

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go all the way to the other side and then
come back down to the center and out.

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So you've got two little threads coming
out and we have the patients tip the

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head back and we tie it down.

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So what it does is it is like a little
corset that we've placed right on the

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muscle, and that's how we use the light
guidance. And when we tie it down,

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it just lifts everything.

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So we don't have to go and open everything
and move the muscles to the center

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and do things like that.

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We're just placing a little support
system hovering right over the muscle,

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and that's how it works,

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and it lifts the glands and then just
helps smooth the muscle contours,

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I might say. We also use it to
make a little cut in the bands,

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and we do that through little
needle punctures where we
actually pass the thread

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around the edge of the muscle and then
we just go back and forth with it and it

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makes a tiny little cut
in the front of the band,

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and that helps to make
these bands less visible.

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So Dr. Mueller, you said
that a thread is used.

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How is this procedure
different from a thread lift?

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Yeah, we get that question
asked all the time,

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and it's a great question
because threads are very popular.

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A lot of people use them in the face to
lift things and make things look better,

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but the difference is very substantial.

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MyEllevate is a light
guided delivery of a normal

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suture material that surgeons would use
in a surgery to sew things together,

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muscles and so on.

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It's a braided polyester stitch about the
size of a thread you'd use to sew on a

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button,

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and we deliver it on the muscle and lift
the skin and the muscle together as a

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composite.

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A thread lift on the other hand is usually
a barbed suture that usually absorbs

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over time,

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and its really sort of goal is to place
it right in the skin itself to kind of

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lift the skin envelope. So MyEllevate
supports and lifts the muscle,

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thread lifts lift the
skin and threads absorb.

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So the results last maybe a year
at the most, whereas MyEllevate,

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you're looking at five
plus years of durability.

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And I couldn't agree more. I think
that's really a critical distinction,

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the level at which the work is being done,

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and we're going to talk a
little about outcomes later,

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but the durability of the procedure is

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substantially different,
and that's really critical,

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critical when you think about when you're
going to have to circle back and maybe

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work on these issues again,

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knowing that you've got half a decade
plus and often quite a bit longer than

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that half decade

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is really a huge selling point
for the procedure in my view.

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I know patients want to know
how we're going to do it,

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how they're going to be
improved, what's going to change,

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but the next question is
always how long does it last?

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And we have a lot of longevity
in American life today.

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We're blessed with decades and
decades of late adult life,

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and so thinking about when
we're going to have to repeat or

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return for additional work becomes
a big part of the equation.

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So I think I'm starting to understand
what's involved in the procedure itself,

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and let's say that I don't like my neck,

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but I'm not exactly sure that
MyEllevate is right for me.

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Can you tell us who is the ideal
candidate for this procedure?

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Of course. Yeah.

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So MyEllevate is it's a great
procedure for someone who is just

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starting to notice a little bit
of droopiness underneath the chin.

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My patients will come in and they'll
say, gosh, I looked at my photos.

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I was at a wedding and someone
took a profile picture of me,

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and I'm noticing that things
are starting to sag. I am 25,

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sometimes 25 year olds start
having a little bit of sagging.

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But I would say my patient
groups are usually 35 to 45 to

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50, and they tell me, I don't
want a facelift or a neck lift,

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but I just want to kind of shape things
and make my jawline look better and

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underneath my chin, and I want
something that will last a long time,

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definitely over a year and
something that will be very

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effective. And so those
patients are great ones.

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And then also sometimes I have a patient
come in and they might be in their

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twenties and they were born with a neck
that's sort of like a ski slope where

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the chin kind of goes down to the chest
and they're so unhappy because they

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just don't have a really nice jawline.

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And so those are great patients where
you can actually kind of help with

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genetics, someone's inherited neck.

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So it really works for anybody who
wants to improve their jawline contours,

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who doesn't have a lot of skin laxity.
If somebody has a lot of loose skin,

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then we would think of a neck lift
or a facelift for those folks.

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I think that's a great summary,
and I do the procedure.

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I haven't had the length
or depth of experience that

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Dr. Mueller does,

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but I've had very favorable
experience with the procedure.

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And I think because of
that patient selection,

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if you're using the procedure for the
right reasons in the right person,

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it totally delivers. And interestingly,

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I had a young lady in her twenties with

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some heaviness in her neck,

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but also some anatomic features
that contributed to bluntness there.

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And I had liposuctioned
her and the fat was gone,

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but she still didn't have the
definition and the sharpness of the

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cervicomental angle,

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medically what we describe as the angle
between the horizontal part under the

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chin and the vertical part of the neck.

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So I circled back and
did MyEllevate on her,

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and that sharpened her up and gave her
a level of definition that in youth she

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never had just because of
the way her anatomy was.

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The other place that I'm curious
though, to hear about your experience,

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because I've thought
about this quite a lot,

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is looking at patients who have had
a facelift or an neck lift because

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the usual failure point
a number of years down

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the line is some return
of the vertical banding,

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some gland ptosis,

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the salivary glands that start
to droop under the jaw and create

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fullness in the neck and
some loss of definition or

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sharpness in that area. So
I've thought a lot about,

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and now that I have you here at my
mercy, I can ask you this question,

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are those patients good If there's
not a lot of skin laxity return,

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but you're seeing the banding or
the gland or one of those issues,

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is this a good minimal way to take
someone who might be five or seven

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years out from a lift,

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really not ready for another full
surgical lift and clean them up

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and give them that extra
measure of longevity?

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Yeah, no, I love the point you're
making when you talk about the bands,

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the visibility of the bands or the glands
and just like what you talked about

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earlier about your patient who'd had
liposuction and you were able to bring

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that patient back and
really optimize the results.

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So with facelift patients,

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it's a great tool to sort of bridge the

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procedure,

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give that patient a really renewed neck
because you know how it is that the

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face always holds up when
we do facelifts and neck,

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it's the neck that kind
of gives out first.

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Exactly.

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So the ability to go in, use MyEllevate,
make a little cut in those bands,

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sometimes we treat the skin with energy
and there's many different types to help

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kind of tighten that skin envelope
and then place MyEllevate.

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It's a great way to just give your
patient a little re-up of their procedure.

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So yes, I use it in that
application quite often.

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Yeah, again, I'm newer to this procedure,

227
00:14:11,620 --> 00:14:14,980
so I'm starting in that direction,

228
00:14:14,981 --> 00:14:19,600
but I thought about it for a long
time and I just think it's those

229
00:14:19,601 --> 00:14:24,160
bands that they're notorious
sometimes even within a year or two,

230
00:14:24,190 --> 00:14:27,610
but certainly after a number of years,

231
00:14:28,420 --> 00:14:33,400
that's what you start
seeing in the neck lift

232
00:14:33,401 --> 00:14:35,530
that's starting to wear out,

233
00:14:36,070 --> 00:14:40,750
and it's really great to have a way
to give that a little freshening

234
00:14:41,350 --> 00:14:43,870
without going back for a full relift.

235
00:14:44,890 --> 00:14:49,300
Oh, absolutely. And the nice thing too
is you can do it under local anesthesia,

236
00:14:49,750 --> 00:14:54,350
do it in about an hour.
They have this new contour,

237
00:14:54,410 --> 00:14:56,870
renew the results, and
they're out the door.

238
00:14:57,230 --> 00:14:59,450
And same thing is true
with younger patients.

239
00:14:59,630 --> 00:15:04,550
You're giving them results that
will really overperform what you do

240
00:15:04,560 --> 00:15:07,670
with liposuction alone,
which I love that as well.

241
00:15:07,671 --> 00:15:11,720
It really kind of sets me apart from
my competitors here in Beverly Hills.

242
00:15:13,040 --> 00:15:16,730
And that banding in the neck, it is again,

243
00:15:16,731 --> 00:15:21,470
a notorious failure point either in
the early result and certainly in the

244
00:15:21,471 --> 00:15:22,400
late result.

245
00:15:22,401 --> 00:15:27,230
And there are a lot of very
aggressive approaches to

246
00:15:27,290 --> 00:15:29,780
trying to treat the muscle in the neck,

247
00:15:30,620 --> 00:15:35,060
very extensive kinds of
reworkings of the muscle,

248
00:15:35,780 --> 00:15:40,760
but it's not clear on a database
that they're any better on average

249
00:15:40,820 --> 00:15:44,090
than MyEllevate. That might be
an interesting area for study.

250
00:15:44,240 --> 00:15:48,920
And at the Aesthetic
Society meeting a month ago,

251
00:15:49,370 --> 00:15:53,300
there was a whole panel on these
very aggressive neck approaches,

252
00:15:53,630 --> 00:15:55,670
but it just strikes me

253
00:15:57,840 --> 00:16:02,810
that this is a very effective
way of dealing with the

254
00:16:02,840 --> 00:16:07,130
vertical banding without
taking that kind of

255
00:16:07,131 --> 00:16:10,160
recovery and that kind of risk on.

256
00:16:11,090 --> 00:16:14,690
And as a plastic surgeon and a
researcher, I'm sort of a data guy,

257
00:16:15,320 --> 00:16:19,430
so I think a lot about outcomes
and evidence-based medicine,

258
00:16:19,880 --> 00:16:23,420
we've discussed this on
the podcast multiple times,

259
00:16:23,990 --> 00:16:28,460
which devices and treatments have data
associated with them and which are

260
00:16:28,461 --> 00:16:33,440
driven purely by marketing.
And so Dr. Mueller,

261
00:16:33,441 --> 00:16:37,310
there've been a few excellent
publications dealing with outcomes,

262
00:16:37,311 --> 00:16:39,650
including durability with MyEllevate.

263
00:16:40,040 --> 00:16:43,250
Can you just outline the
findings in those studies?

264
00:16:43,850 --> 00:16:45,860
Absolutely. There were two studies,

265
00:16:45,861 --> 00:16:48,680
really the two cornerstone
studies for MyEllevate,

266
00:16:48,770 --> 00:16:53,150
and the first one I published
with Sherrell Aston in 2012.

267
00:16:53,690 --> 00:16:56,870
And in that paper we showed the
strength of the retaining ligaments,

268
00:16:56,900 --> 00:16:59,150
and that's what we used
to anchor the sutures.

269
00:16:59,570 --> 00:17:04,520
And so that shows that those ligaments
will hold 10 pounds of force before

270
00:17:04,521 --> 00:17:08,750
they break, and we prove that
they're the same as muscles.

271
00:17:08,930 --> 00:17:09,621
So right there,

272
00:17:09,621 --> 00:17:13,850
it shows you that anchoring sutures
around those ligaments is as good as

273
00:17:13,851 --> 00:17:16,610
anchoring sutures in muscles.
That was very important.

274
00:17:16,611 --> 00:17:18,140
That's sort of the basic science.

275
00:17:18,770 --> 00:17:23,030
Then I spent the next decade
perfecting the MyEllevate procedure,

276
00:17:23,031 --> 00:17:24,440
and I'm so proud.

277
00:17:24,441 --> 00:17:29,120
We published a paper in April
of 2023 in the Aesthetic Surgery

278
00:17:29,121 --> 00:17:33,500
Journal, 391 patients, five surgeons,

279
00:17:33,501 --> 00:17:38,130
four different centers, all with
less than 5% complication rate.

280
00:17:38,510 --> 00:17:43,070
And this is insurgents with
varying years of experience,

281
00:17:43,640 --> 00:17:48,410
which prove that the learning curve
is quick, the procedure is safe,

282
00:17:48,860 --> 00:17:52,620
and outcomes were very consistent,
which made me very happy.

283
00:17:52,710 --> 00:17:54,480
And I was an equal
contributor to this study.

284
00:17:54,481 --> 00:17:58,680
I didn't have all my patients in
there than just a few from the others.

285
00:17:58,690 --> 00:18:01,680
So I love it. I mean, that
makes me really happy. Now,

286
00:18:01,681 --> 00:18:05,190
the follow-up was a little short on the
paper because it's a brand new paper,

287
00:18:06,630 --> 00:18:08,340
but the good thing is that paper,

288
00:18:08,341 --> 00:18:13,050
what it shows is this is a procedure that
can be taught and can give really nice

289
00:18:13,051 --> 00:18:15,690
results with a very low complication rate.

290
00:18:16,380 --> 00:18:20,070
And let me ask you one more thing,
which we didn't touch on yet,

291
00:18:20,071 --> 00:18:23,550
but is also a really important
feature. The procedure.

292
00:18:23,910 --> 00:18:28,740
Say a little bit about what the
recovery time is like because facelift

293
00:18:28,741 --> 00:18:32,430
is not a disaster as a recovery procedure,

294
00:18:32,440 --> 00:18:36,960
but there is a significant period of
time where there's swelling and firmness

295
00:18:37,020 --> 00:18:41,550
and the potential even for quite a bit
of bruising if you get a little unlucky.

296
00:18:42,000 --> 00:18:46,200
So contrast that with what
MyEllevate is able to accomplish

297
00:18:46,830 --> 00:18:49,020
in a typical treatment.

298
00:18:49,980 --> 00:18:50,813
Sure, sure.

299
00:18:51,240 --> 00:18:54,990
So the beautiful thing about MyEllevate
is we're doing everything through little

300
00:18:54,991 --> 00:18:58,920
punctures, and these are just a little
bit smaller than two millimeters.

301
00:18:59,850 --> 00:19:01,500
And so we're not opening the skin,

302
00:19:01,510 --> 00:19:05,700
we're not making big incisions like
you would in a facelift or a neck lift.

303
00:19:06,240 --> 00:19:10,650
And I think the key component is we're
not lifting that skid up off the muscle,

304
00:19:10,651 --> 00:19:13,830
meaning that we're cutting away those
little attachments, the ligaments.

305
00:19:14,400 --> 00:19:16,170
So the procedure is sort of,

306
00:19:16,350 --> 00:19:19,260
I always tell my patients sort of
organic meaning that we're just keeping

307
00:19:19,261 --> 00:19:22,530
everything together and all we're doing
is just weaving in a little suture in

308
00:19:22,531 --> 00:19:26,460
there to help lift everything. So
the recovery times are much shorter.

309
00:19:26,850 --> 00:19:31,620
We're talking bruising for six to 10
days versus a facelift or a neck lift.

310
00:19:31,680 --> 00:19:36,210
You're looking at 10 days
to 14 days of some bruising.

311
00:19:36,240 --> 00:19:38,550
And then the scar tissue
sometimes can be lumpy,

312
00:19:38,551 --> 00:19:43,530
bumpy in those cases because there's
that potential space for fluid to collect

313
00:19:43,531 --> 00:19:44,880
when you've lifted up the skin.

314
00:19:45,660 --> 00:19:50,430
So everything just by design of the
procedure makes it less invasive.

315
00:19:50,440 --> 00:19:53,400
And then just keeping the skin
connections to the muscle,

316
00:19:53,401 --> 00:19:54,870
I think that helps a lot.

317
00:19:55,680 --> 00:19:57,720
Yeah, because drainage of swelling,

318
00:19:57,721 --> 00:20:02,280
I mean the less tissue you're
disrupting all the normal channels for

319
00:20:02,281 --> 00:20:06,990
drainage of swelling that that causes that

320
00:20:06,991 --> 00:20:11,430
firmness in the tissues
that still intact and

321
00:20:11,431 --> 00:20:14,040
allows speedy recovery. I have to say,

322
00:20:14,400 --> 00:20:19,350
I've really been struck by
how short and how minimal

323
00:20:19,351 --> 00:20:22,320
the recovery is with this procedure.

324
00:20:23,250 --> 00:20:27,990
And my patients constantly
make me a little crazy

325
00:20:27,991 --> 00:20:29,820
by going out in public,

326
00:20:29,821 --> 00:20:34,740
going back to work the same day of
the procedure or the next day when

327
00:20:34,741 --> 00:20:39,480
I ask them to please rest quietly
at home for a day or two so they

328
00:20:39,481 --> 00:20:43,050
don't bruise or swell unexpectedly,
but they feel well enough.

329
00:20:44,070 --> 00:20:49,000
And you do wear a garment in that
first couple of days and some

330
00:20:49,001 --> 00:20:51,220
neck support for a longer period of time.

331
00:20:51,221 --> 00:20:55,540
But for my patients who feel comfortable
being out in public with that,

332
00:20:56,800 --> 00:20:58,960
it really hasn't slowed them down much.

333
00:20:58,961 --> 00:21:03,520
And I've really been very
pleasantly surprised by how

334
00:21:03,640 --> 00:21:07,840
well they look when I see them
back in the office at five days and

335
00:21:08,500 --> 00:21:10,390
at a couple of weeks and so on.

336
00:21:10,391 --> 00:21:14,980
So the recovery in the busy 21st

337
00:21:14,981 --> 00:21:19,960
century lifestyle is another key
component of what the procedure

338
00:21:19,961 --> 00:21:20,794
can offer.

339
00:21:21,730 --> 00:21:26,200
Yeah, I think that the true value of
the procedure is as you were saying,

340
00:21:26,201 --> 00:21:30,610
that short recovery time and
also just the patients feeling

341
00:21:30,611 --> 00:21:35,500
confident enough to go back
out and go back to work or do

342
00:21:35,501 --> 00:21:36,640
their normal activities.

343
00:21:36,641 --> 00:21:41,410
And there's so much value in that
because when I used to open the neck

344
00:21:41,740 --> 00:21:45,520
and I love technically challenging
procedures, my patients don't though,

345
00:21:45,521 --> 00:21:49,870
I don't think, they would be beat up for
a long time, and they were mad at me.

346
00:21:50,410 --> 00:21:54,370
And so the nice thing about this
procedure is they're always very happy.

347
00:21:54,371 --> 00:21:55,540
I'm very happy,

348
00:21:55,990 --> 00:22:00,550
but it kind of flips the paradigm I
believe of minimally invasive because

349
00:22:00,551 --> 00:22:03,610
usually minimally invasive
is minimally effective.

350
00:22:03,970 --> 00:22:07,990
I feel like this is quite effective.
And then you have the long durability,

351
00:22:08,470 --> 00:22:13,060
and I think that's because it's a low
tension support system and we're using the

352
00:22:13,070 --> 00:22:15,340
normal structures of
the body to anchor it,

353
00:22:15,700 --> 00:22:18,340
and we're not putting things
in places they never were.

354
00:22:20,200 --> 00:22:23,800
And I also think it flips
the paradigm in another way,

355
00:22:23,801 --> 00:22:28,150
and I just thought of this as
we are sitting here chatting,

356
00:22:28,750 --> 00:22:33,550
that most patients sort
of put off and put off

357
00:22:33,560 --> 00:22:36,400
and put off getting something
done with their neck.

358
00:22:36,730 --> 00:22:41,650
They're waiting till they're ready
to pull the trigger on getting a neck

359
00:22:41,651 --> 00:22:45,940
lift. And with a short recovery,

360
00:22:45,970 --> 00:22:48,580
a long durability correction,

361
00:22:48,581 --> 00:22:52,630
a meaningful correction of
the deep support in the neck,

362
00:22:53,380 --> 00:22:53,981
really,

363
00:22:53,981 --> 00:22:58,930
it's much to your advantage once you
see some changes there that are starting

364
00:22:58,931 --> 00:23:02,530
to detract from your appearance that are
starting to give you a little bit of an

365
00:23:02,531 --> 00:23:07,480
aging look to jump in and get it
corrected rather than dragging

366
00:23:07,481 --> 00:23:11,200
it out until you need a major restoration.

367
00:23:12,550 --> 00:23:13,480
Absolutely.

368
00:23:13,780 --> 00:23:18,700
And today with everybody
using social media and

369
00:23:18,940 --> 00:23:22,210
so aware of their jawlines and so on,

370
00:23:22,750 --> 00:23:26,290
this just gives patients an
earlier way, as you were saying,

371
00:23:26,291 --> 00:23:29,920
to kind of slow down the process of aging,

372
00:23:30,400 --> 00:23:34,990
but to also use that younger skin
elasticity because it's there,

373
00:23:35,380 --> 00:23:39,280
but those muscles are the darn things
that cause everything to kind of collapse.

374
00:23:39,580 --> 00:23:44,140
So you're getting in there and lifting
the foundation and then keeping that

375
00:23:44,150 --> 00:23:46,940
patient looking great for
a longer period of time,

376
00:23:47,270 --> 00:23:50,360
and maybe later down the road they'll
need a facelift or a neck lift.

377
00:23:50,690 --> 00:23:54,440
But the nice thing is all you've done
is placed two little strands of suture

378
00:23:54,441 --> 00:23:58,940
there, so it's an easy one to go in
and do a facelift or a neck lift later.

379
00:23:59,990 --> 00:24:02,990
Now let's look to the future
for a moment, Dr. Mueller.

380
00:24:02,991 --> 00:24:05,360
What might be coming next
to improve MyEllevate?

381
00:24:06,860 --> 00:24:11,690
I think MyEllevate, because I've
been working on it for so long,

382
00:24:12,440 --> 00:24:13,550
I can say this,

383
00:24:13,551 --> 00:24:17,990
that my dream was always to get
it into other surgeon's hands,

384
00:24:17,991 --> 00:24:21,830
the technology and the procedure and
see what they would come up with.

385
00:24:22,280 --> 00:24:24,110
And already a couple surgeons,

386
00:24:24,111 --> 00:24:28,910
Dr. Barry DiBernardo and Jason Pozner
came up with a way of anchoring the suture

387
00:24:28,920 --> 00:24:31,910
behind the ear when we
do a little skin removal.

388
00:24:31,911 --> 00:24:36,200
So we can also use the procedure combined
with a little bit of a skin tuck.

389
00:24:36,650 --> 00:24:40,430
And so the nice thing is if you have a
patient who's got a little bit of excess

390
00:24:40,431 --> 00:24:44,180
skin and the patient doesn't want to
have a big facelift or a neck lift,

391
00:24:44,450 --> 00:24:47,360
we can do this sort of what
we call a MyEllevate Plus.

392
00:24:47,720 --> 00:24:50,180
So they came up with a way of
anchoring it behind the ear,

393
00:24:50,181 --> 00:24:51,410
which I think is great.

394
00:24:52,040 --> 00:24:55,610
So I think surgeons are
very creative by nature,

395
00:24:55,970 --> 00:25:00,470
so I think surgeons will find sort of
little different applications of weaving a

396
00:25:00,471 --> 00:25:01,940
suture underneath the skin.

397
00:25:03,950 --> 00:25:06,170
We've used it on midface lifting.

398
00:25:06,380 --> 00:25:09,710
It's a little bit more challenging because
you've got to balance the right face

399
00:25:09,711 --> 00:25:12,140
with the left face, whereas with the neck,

400
00:25:12,150 --> 00:25:16,820
the thing I love is it's one
continuous half arc suture passage,

401
00:25:17,090 --> 00:25:19,700
so it kind of equalizes asymetry for you,

402
00:25:20,210 --> 00:25:24,530
but also the brow using it as a way
to elevate and shape the eyebrows.

403
00:25:25,280 --> 00:25:28,400
I think there's a lot of different
things that we can do with it,

404
00:25:28,790 --> 00:25:33,770
but I'm looking to other surgeons
to come up with crafty ways of

405
00:25:33,860 --> 00:25:35,780
using the technology.

406
00:25:37,640 --> 00:25:39,500
Dr. Bass, would you like
to add any takeaways?

407
00:25:40,490 --> 00:25:45,200
This is all related to all the
basic principles we often talk

408
00:25:45,201 --> 00:25:46,850
about on the podcast.

409
00:25:46,880 --> 00:25:50,960
It's essential to have a good working
relationship with your surgeon,

410
00:25:50,961 --> 00:25:54,920
who's someone who's experienced
in facial rejuvenation.

411
00:25:55,670 --> 00:26:00,200
There's no one best procedure
or treatment for all

412
00:26:00,201 --> 00:26:05,120
patients. It's about matching
your needs at your stage of aging

413
00:26:05,750 --> 00:26:09,710
and what works well in your
selected surgeon's hands.

414
00:26:11,210 --> 00:26:16,010
Everyone feels differently about
when or even if they will ever

415
00:26:16,011 --> 00:26:18,770
get a surgical neck lift.

416
00:26:19,490 --> 00:26:24,080
MyEllevate is something that can
address significant concerns in the

417
00:26:24,090 --> 00:26:28,730
neck that offers
research-based data-driven

418
00:26:28,731 --> 00:26:33,560
approach with obvious improvement,
minimal recovery time,

419
00:26:33,890 --> 00:26:35,720
and excellent durability.

420
00:26:36,710 --> 00:26:41,450
It doesn't fully replace the neck lift
for older patients with substantial skin

421
00:26:41,451 --> 00:26:42,284
laxity,

422
00:26:42,590 --> 00:26:47,400
but it's an outstanding option for
patients at the right stage of aging that

423
00:26:47,401 --> 00:26:50,790
preserves the neck lift
option for later in the game.

424
00:26:52,980 --> 00:26:54,210
And Dr. Mueller,

425
00:26:54,211 --> 00:26:59,130
it's been a delight to have
you and to hear about the

426
00:26:59,220 --> 00:27:03,930
journey of innovation
and the way you problem

427
00:27:04,410 --> 00:27:08,160
solve from things that were
observed in the clinic and

428
00:27:09,840 --> 00:27:13,860
the long period of time that you
persevered to really make it happen,

429
00:27:15,240 --> 00:27:20,190
rather than just either giving up or
doing something that wasn't effective

430
00:27:20,460 --> 00:27:22,740
to really get to the point of perfection.

431
00:27:23,580 --> 00:27:27,330
So thank you for joining us and sharing
the experience. I really appreciate it.

432
00:27:27,810 --> 00:27:32,400
Thank you so much. It's been a true honor
and have a wonderful day. Thank you.

433
00:27:33,060 --> 00:27:36,990
I'll echo Dr. Bass and say thank you
again to Dr. Mueller for joining us today

434
00:27:36,991 --> 00:27:39,900
and sharing your innovative journey
in plastic surgery with all of our

435
00:27:39,901 --> 00:27:40,734
listeners.

436
00:27:41,970 --> 00:27:45,660
Thank you for listening to the Park
Avenue Plastic Surgery Class podcast.

437
00:27:46,110 --> 00:27:47,580
Follow us on Apple Podcasts,

438
00:27:47,610 --> 00:27:49,710
write a review and share
the show with your friends.

439
00:27:50,100 --> 00:27:53,220
Be sure to join us next time to avoid
missing all the great content that's

440
00:27:53,230 --> 00:27:56,730
coming your way. If you want to
contact us with comments or questions,

441
00:27:56,760 --> 00:27:57,630
we'd love to hear from you.

442
00:27:58,140 --> 00:28:02,400
Send us an email at podcast@drbass.net
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443
00:28:03,210 --> 00:28:03,300
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